Motion sickness (unfinished) Flashcards
Cause of motion sickness and main organ for maintaining balance
Caused by the body’s balance, namely by the ears, eyes and brain. The inner ear is the main organ responsible for maintaining balance. When brain is unable to process conflicting inputs from this, nausea and vomiting are the result.
Symptoms of motion sickness
nausea vomiting pale skin/pallor cold sweating abdominal discomfort sighing, yawning, hyperventilation, headache swallowing/salivation
Referral criteria for motion sickness
double check with book
Pregnant patients Breastfeeding patients Children under 8 years Those taking other medications Those that drive and suffer from motion sickness and the length of their journey
Describe the susceptibility of motion sickness in different patient ages and populations
0-2 years generally immune.
2-12 years more susceptible, as well as pregnant and menstruating women,
Lifestyle advice regarding motion sickness
- suffering from fatigue, anxiety or lack of sleep can make you more susceptible
- avoid foods high in protein or salt and avoid heavy, rich meals
- avoid alcohol and smoking
- relax, get plenty of fresh air, try to listen to music and keep calm.
- avoid reading or watching tv in the car/moving vehicle
- look ahead in the car and decrease speed (if possible)
- watch the horizon on a boat and try to stay in the middle at roughly sea leave and keep horizon in view
- if on a plane, try to sit near the wings
- keep still - restrict head movements (by use of a travel neck pillow)
- use booster seats in children as they are less likely to feel sick if they can see out of the car.
Name 3 drugs used for the treatment of motion sickness and their respective drug classes
Promethazine (antihistamine with anticholingeric action)
Hyoscine hydrobromide(anticholingeric agent)
Cinnarazine (antihistamine with anticholingeric action)
Promethazine
directions and doses dependent on age
Motion sickness
Child 2-4 years 5mg at bedtime, night before travel. Repeat following morning if necessary Child 5-9 years 10mg as above Child 10-17 years 10-25mg as above Adult 20-25mg as above
Promethazine side effects
Motion sickness
Drowsiness Dizziness Tired feeling/fatigue Ringing in the ears (tinnitus) dry mouth stuffy nose insomnia
Promethazine warnings
Motion sickness
Not for children aged under 2 years
Caution in epilepsy
Not to be used in pregnant or breastfeeding patients
Not to be used in liver impairment
Check interactions with regular medicines
Promethazine counselling
Motion sickness
Drowsiness can affect driving
Lasts longer so good for long journeys
Takes 2 hours to kick in, lasts for 24 hours
Hyoscine hydrobromide instructions
Motion sickness
Take 20 mins before leaving
Children 4-9 years: 0.5-1 tablets
75-150mg - dose to be taken up to 30 minutes before the start of the journey, then 75-150mg every 6 hours if required. Maximum 450mg per day
Children 10-17 years and adults
1-2 tablets
150-300mg, dose to be taken up to 30 minutes before the start of the journey, then 150-300mg every 6 hours if needed, maximum 900mg per day
Hyoscine hydrobromide side effects
Motion sickness
constipation
dry mouth
blurred vision
drowsiness
Hyoscine hydrobromide for motion sickness
warnings
Do not use if you have:
-glaucoma
-high blood pressure
-urinary problems
-heart disease
Caution if used with other antimuscarinics
Not recommended in pregnancy but if benefit outweighs risk it is ok
Hyoscine hydrobromide for motion sickness
counselling
short duration of action: up to 4 hours
repeated doses for long journeys
Children 4 years of age or older
can affect driving
Cinnarazine doses
motion sickness
5-12 years: 1 tablet to be taken 2 hours before journey and then 0.5 tablet after every 8 hours
Adults: 2 tablets before journey and 1 tablet after every 8 hours
